Validation of screening questionnaires for evaluation of knee osteoarthritis prevalence in the general population of Singapore. (21st December 2017)

• Record Type: Journal Article
• Authors: Leung, Ying‐Ying; Ma, Stefan; Noviani, Maria; Wong, Steven B.‐S.; Lee, Chee Min; Soh, Irene A.‐L.; Thumboo, Julian
• Is Part Of: International journal of rheumatic diseases. Volume 21:Number 3(2018)
• Page Start: 629
• Page End: 638
• Publication Date: 2017-12-21
• Subjects: symptomatic knee osteoarthritis -- screening -- epidemiology -- prevalence; Rheumatology -- Periodicals; Rheumatology -- Asia -- Periodicals; Rheumatology -- Pacific Area -- Periodicals; Rheumatic Diseases -- Periodicals; Connective Tissue Diseases -- Periodicals; Immune System Diseases -- Periodicals; 616.723
• DOI: 10.1111/1756-185X.13252
• Languages: English
• ISSNs: 1756-1841

Abstract

Abstract: Background: The prevalence of symptomatic knee osteoarthritis (KOA) in Singapore is unknown. We aimed to: (i) validate questionnaires to screen for symptomatic KOA; and (ii) estimate the prevalence of symptomatic KOA in Singapore using the validated algorithms. Methods: Subjects aged ≥50 years were evaluated for symptomatic KOA based on American College of Rheumatology clinical and radiographic criteria in a rheumatology clinic, and completed three sets of adapted screening questionnaires. The better performing screening questionnaire with adequate sensitivity and specificity was adminitered to a nationally representative sample of survey subjects ( n = 3364) to estimate the weighted prevalence of symptomatic KOA in Singapore. Results: Out of 146 subjects evaluated in the clinic, 45 had symptomatic KOA. A screening algorithm which consisted of three KOA symptoms or one symptom plus physician‐diagnosed KOA produced high specificity (0.95, 95% confidence intervals [CI]: 0.88–0.98) but low sensivity (0.44, 95% CI: 0.30–0.60). Replacing the term 'KOA' with 'physician‐diagnosed ageing‐related knee problem' improved the sensivity (0.62, 95% CI: 0.47–0.76) without significantly compromising the specificity (0.87, 95% CI: 0.79–0.93). The prevalence of symptomatic KOA weighted to the Singapore population distribution were 4.7% and 11%, using the most conservative and more liberal algorithms, respectively. There was a sharp rise in prevalence after age of 40. The weighted prevalence of KOA was higher in women and among Indian and Malay than Chinese. Conclusion: Our study adapted and validated questionnaires to the local context to screen for symptomatic KOA. We estimated the prevalence of symptomatic KOA in Singapore utilizing the better‐performing algorithms.